Nikki Takes On World’s Toughest Race….AND WINS!!!

Today we catch up with 2015 BADWATER 135 FEMALE 1st PLACE WINNER
For those who have followed since the start of the website, Nikki was my first athlete interview before her debut at BADWATER in 2014, now 12 months later she has managed to secure the ultimate podium position!

What was different about your preparation over the last twelve months that helped get you over the line in first place this year?

Reflecting back on the past 6  – 12 months compared to last years’ race prep I definitely was going more quality rather than quantity this year.  I was doing 3 key speed sessions per week, combined with 3 hot yoga sessions and lots of 2nd sessions that were spent hiking in the Dandenongs.

Did you do anything different in preparation for the race once you landed in the United States?

Not really.  As we had left a cold miserable winter we really made sure we got out in the middle of the day and trained.  So I am sure it looked quite funny for people driving down the strip in Vegas to see David and myself running along at midday in 45deg heat.

Last year you talked about including more cross training and resistance training into your program, did this happen? Ha ha, yes well I do remember saying this to you however I didn’t manage any resistance training but I did start doing hot yoga 2-3 times per week and the odd reformer pilates class.  I had a pretty busy 6 months at work so I didn’t have as much time to train, however I think looking back I trained smarter.

This year the race actually travelled through Death Valley how did you find it, and what kind of temperatures were you dealing with this year?

It was so exciting to finally be on the original course.  I LOVED IT.  To be running through Death Valley was quite surreal and as silly as it might seem to some people I actually kept reminding myself during the race just how lucky I was to be there.  Only 100 people are invited to do this race, the best of the best from around the world and WOW I was one of them.  When the race started at 11pm at night it was (110 farenheit – 43 deg) and the hottest it got to during the middle of the day on the 2nd major climb the 12.2 mile climb up Panamint Pass was (118 faranheit – 47.78 deg). I was pouring water over myself and it was evaporating within minutes.

You managed to cover the enormous 217km trail in 27hours 23minutes and 27 seconds! How many stoppages did you have over that time and did you manage to get any sleep in at all?

I stopped twice during the whole race.  The first time was for 4 minutes to deal with blisters and the second time was for about 10minutes when I was having trouble with the blisters and my shoes rubbing.  My race plan was to never stop and I had a race strategy of running for 13 minutes and walking for 2 minutes just to break up the race.  The walk was enough to energise me and to give my legs enough of a break to keep running strong.  Looking back I didn’t sleep from 10am Tuesday morning until 1am Friday morning because I was on such a high.

A huge part of this kind of racing is the mental strength required to just keep fighting, how did you train for this part of your preparations?

I think the mental strength comes from years of racing and competing and I think being confident in your training.  I knew going into the race I had done the training, I was fresh, I had tapered well, I was well rested and I knew the distance wasn’t a problem.  I try to be in the moment and enjoy every aspect of the race, even the tough times I try to embrace as its all part of it and I know that everybody out there is hurting.  I was actually lucky that I didn’t hurt that bad so had a really enjoyable experience.  I kept my garmin watch on Melbourne time so during the race I was thinking about my son back home who couldn’t be there this year, thinking of him going off to school and then going off to footy training etc.  I thought of my family and my friends and all of this distracted me when I had a few dark patches.

Has there been a change in your choice of shoes this year?

I wore Hoka’s again at Badwater this year and once again they were amazing.  I was smarter this year and purchased two pairs of HOka’s that were a size bigger than I normally wear and this helped later in the race when me feet were quite swollen from the heat and were badly blistered.

Have you been lucky enough to stay away from injuries outside of the occasional blistering? touch wood, I have never been injured.  I tend to listen to my body and I do have regular Physio & massage and I definitely think the pilates and hot yoga helped to keep me injury free. As for the blisters, well I still haven’t mastered not getting them – maybe I need to get some advice from you Jackson for next years race???

What are the next big things to complete on your list of achievements? Will you return to in 2016 to badwater to defend your title?

I will be competing in the Australian 100km team going to Amsterdam for the World Champs on the 12th September.  Then after this I hope to get a start in one of my favourite races in Australia Coast to Kosci.

At this stage my amazing partner David and I would both love to go back to Badwater in 2016 and complete the race together. I feel if I can get my feet and blisters sorted and all the planets aligned during the race then I could take another 30mins or so off my time from this year, but that is a big ask but it’s so exciting to dream big and that is one thing I encourage everybody to do.

I still can’t believe I am the 2015 Female Badwater winner, it just goes to show that with hard work and dedication and daring to dream big that your dreams actually can come true………

Thanks for talking to me Nikki all the best


Jackson McCosker
Director /Chief Editor

In-Grown Toe Nails: What you should really do!

In-Grown toe nails have been at the centre stage when it comes to old wives tales. From cutting your nails straight across to cutting a wedge from the centre a number of home remedies have been floated for dealing with nails which are causing soft tissue damage and pain which has been described as being up there with child birth. In this brief article we will look at what can be done conservatively as well as what surgical options are available in the treatment of ingrown toe nails and preventative measures which can be taken if you think you may be at risk of such an issue.

Conservative Treatment
In many cases a non re-occurring in-grown toe nail can be easily treated by a podiatrist with the use of sterilized equipment. It can be relatively pain free, with very little risk and you should be able to return to work or play instantly. In some circumstances the prescription of antibiotic may be required if a local infection is present.
After this has been complete the podiatrist may supply you with some tips in reducing the chances of re-occurrence, such as; using a tooth brush to clean the area, taping the plantar aspect of the toe away from the in-growing side or a change in footwear.
If the ingrown toe nail continues to re-occur over a number of weeks or months then a more aggressive option may be required.

Surgical Treatment
The process of surgical intervention for ingrown toe nails is relatively simple and low risk in the world of surgery; however, there is a ten percent chance of the surgery not working. The podiatrist will explain much of the following information in depth and then have you sign a legal document regarding consent and acknowledgement of risks.
If you have previously had issues associated with injections the practitioner will ask that you bring another person to the procedure with you for support and to drive you home. In some circumstances you may be asked to visit the GP to have some anti-anxiolytic prescribed to limit stress around the time of surgery.
Secondly, you will be placed in the newly cleaned podiatry chair with a drape and betadine or chlorhex wash. The podiatrist will then begin to inject a local anesthetic into the toe and massage the area for increased uptake into the tissue. Once complete anesthesia has been achieved then the podiatrist will continue with the procedure.
A tourniquet will be placed over the toe to reduce blood supply and an eponychium retractor used to separate the toe nail from the connective tissue of the toe. Once the toe nail has been detached from the digit itself, a number of straight line cuts can be made down the line of the toe nail to the distal edge of the nail matrix. A nail splitter can then be used to separate the pathological nail from the rest of the nail and the nail matrix before a set of mosquito forceps are used to remove the nail spike in completion.
Finally a small amount of the chemical phenol will be used to destroy the nail matrix and reduce the chances of the slither of nail returning. Once the podiatrist is of the belief that the tissue has been successfully damaged he will then remove the tourniquet from the toe and encourage bleeding to dilute the phenol. An iodine based product is then applied to the area to limit further chance of infection and the toe dressed with a thick layer of gauzed and highly visible tape to protect the toe and make other aware that it has had trauma to it.
Although subjective, there is often very little pain after surgery and work or play can begin within 2 days of the procedure taking place. Most of the time the podiatrist will encourage a number of short visits post surgery where they are able to wash and redress the area of surgery to further reduce infection risk as well as inspect for any sign of pathological tissue.

So there you have it, a very simple no-nonsense article about how to best deal with ingrown toe nails and how to best prevent them from occurring in the first place. When having issues such as ingrown toe nails looked at do not just look for the cheapest option of treatment as this can lead to further issues down the track, explore your options and weigh up the best value intervention for the money which you are outlaying.
Until next time, thank you for reading.

Jackson McCosker
Director /Chief Editor

Recoiling in Pain: Achilles Tendon Injury

As the Netball World Champions rev up in Sydney this week, I thought we would take this chance to have a look at one of the more common injuries which occur in the game – outside of knees and rolling ankles. That leaves us with the achillies tendon, the major tendon complex of the lower leg and an area of the body that most people who have even dabbled in competitive sport would have felt a niggle from here and there.
The achillies tendon and how it is viewed, how it is assessed and how it is treated has changed a lot over the last 10 years so let’s have a look at what the current research says.

The achillies tendon is formed in two separate mechanisms. The first is the converging of the gastrocnemius and soleus aponeurosis 12cm above the calcaneal insertion. The Second is the with gastrocnemius aponeurosis inserting directly into the soleus aponeurosis. The achillies tendon has a round shape proximately, however flatten in the distal 4cm before insertion. The fibers of the tendon spiral approximately 90deg to allow for maximal elongation and energy storage release on propulsion.
The tendon is enveloped in a para-tendon consisting of two layers which originate from the deep fascia of the leg.
Tendons are stiff, resilient, high tensile strength incorporating anatomical structures which can stretch up to 4% before damage may occur. A number of theories resonate with the development of achillies tendon injury, the most prominent being overuse stress, however, other theories include; poor vascularity, poor flexibility, gender, genetics, metabolic factors and endocrine factors.

Achillies tendinopathy is a common degenerative injury among athletes who are involved in a lot of running. Development of the condition can occur due to a number of issues including; muscle power and tendon elasticity imbalance, a sudden increase in training intensity or duration and inadequate warm up or stretching before the completion of an explosive activity (B). Achillies tendinopathy in middle-long distance runners compared to both white collar and blue collar workers has been found to be statistically significant p <0.001 (Kujala, Sarna, & Kaprio, 2005).

When trying to best diagnose a suspect achillies tendinopathy, a full history should be received covering past treatment, medication, medical conditions, training patterns, past training patterns and footwear use. Palpation of the achillies tendon at insertion mid portion, origin and surrounding tissues should be complete and in many circumstances the use of US or MRI may be appropriate to confirm the diagnosis.
It is suspected that tendon degeneration begins long before symptoms begin and may even remain asymptomatic in some cases. Early diagnosis is of practical relevance particularly in high performance sport. Despite popular belief (Hirschmuller, et al., 2012)found there to be no significant link between gender and achillies tendinopathy development.

When clinically managing a patient it is important to address their expectations of performance and return to sport by supplying them with a modified and sensible training plan or referring them to someone who may be able to develop a program like this for them. The activity which is believed to have instigated the problem should be ceased in the acute stages so that collagen fibers can repair and rehabilitation activities involving loading the achillies can begin to stimulate the remodeling process.
(Kader, Saxena, Movin, & Maffull, 2002) found that an eccentric loading program had a statistically significant outcome in the rehabilitation of the achillies tendon, over that of a concentric loading program. When looked at from a sport specific point of view concentric based training is the primary educated tool for most training program outside of rehabilitation and therefore the eccentric stage of movement are neglected hence we can revisit that debate of imbalance in power of the muscles vs elasticity of the tendon and ability to absorb heavy load under stress.
The use of a 12-15mm heel raise (inclusive of heel drop of shoe) has been found to be clinically significant, however, has not been found to be evidently substantial as an offloading mechanism. The use of cryotherapy aims to reduce the metabolic rate of the achillies tendon, decreasing extravasation of blood and protein from new capillaries found in the tendon as well as producing an analgesic effect.
It is suggested that surgical intervention or opinion be sort after 6months of non-effective conservative treatment, however it should also be mentioned that poor outcomes are regularly seen for those patients with long standing issues, therefore to manage the risk of undertreating a patient it may be worth referring them for surgical opinion much earlier.

Furthermore, adequate dorsiflexion range of motion is essential during gait (both walking and running), walking stairs and as part of landing mechanics. Dorsiflexion during landing activities of specific sports is required for the absorption and dissipation of the high Ground Reaction Forces encounted upon ground contact. If dorsiflexion range of motion is inadequate, it can be inferred that increased loading of the plantarflexor complex. Ankle injuries account for approximately 20-30% of all sporting injuries, this is inclusive of any soft tissue which crosses the ankle joint ala achillies tendon. Inadequate dorsiflexion has been noted to increase the risk of ankle joint sprain, fractures or musculoskeletal injuries during sport.

If you have ever seen a sportsperson do a complete achillies tendon rupture or you have done one yourself, you would know how excruciating it can be. The best opportunity you have to avoid such pain is to ensure you are participating in a preventative strength and conditioning program to ensure that achillies tendon and subsequent musculature are in robust form to take on whatever challenges you as an athlete through at it.

Until next time, thanks for reading.

Jackson McCosker
Director /Chief Editor


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